Dermoscopic Patterns in Granulomatous Diseases: A Narrative Review

Dermoscopy has gained increasing recognition in recent years as a valuable non-invasive supplementary tool in diagnosing various skin disorders. However, a comprehensive overview of the distinguishing features of various cutaneous granulomatous diseases remains limited. This narrative aims to summarize the overlapping dermoscopic patterns reported across various diseases such as leprosy, cutaneous tuberculosis, Mycobacterium marinum, granuloma annulare, necrobiosis lipoidica, sarcoidosis, granulomatous variant of rosacea, annular elastolytic giant cell granuloma, and lupus miliaris disseminatus faciei. Across these conditions, several overlapping dermoscopic features were observed including, yellow-orange structureless areas, white structureless areas, linear, dotted and branching vascular patterns. These shared patterns can limit early recognition and diagnostic specificity. When interpreted alongside clinical features, dermoscopy may help narrow the differential diagnosis. However, dermoscopy alone is inadequate for definitive diagnosis; histopathology remains the gold standard. This narrative highlights the overlapping dermoscopic features of various cutaneous granulomatous diseases, emphasizing its role as a complementary tool.